There are limited data on the prevalence and treatment of familial hypercholesterolemia
(FH) among Israeli adults who experience premature acute coronary syndrome (ACS).
This study aimed to assess the prevalence of FH among young Israeli adults with ACS,
examine the rates of lipid-lowering therapy administration, and determine low-density
lipoprotein-cholesterol (LDL-C) levels 1 year after ACS. Patients aged ≤55 years hospitalized
for ACS at Meir Medical Center between 2018 and 2019 were included. Probable/definite
FH was defined using the Dutch Lipid Clinic criteria. Outcomes included the proportion
of patients with probable or definite FH, rate of use of lipid-lowering medications,
LDL-C levels 1 year postadmission, and major adverse cardiovascular and cerebrovascular
events during 30 months of follow-up. The study population comprised 687 young adults
with a median age of 48.5 years. Definite/probable FH was present in 61 patients (8.9%).
At 1 year of follow-up, the proportions of patients without FH who had LDL-C levels
<70 and <55 mg/100 ml were higher than those of patients with FH (55.9% vs 18%, p
<0.001 and 35.8% vs 11.5%, p <0.001, respectively). At 1 year of follow-up, only 47.5%
and 22% of patients with FH were treated with ezetimibe and proprotein convertase
subtilisin/kexin type 9 inhibitor than were those without FH. The incidence of major
adverse cardiovascular and cerebrovascular events was significantly higher among patients
with FH. In conclusion, clinically defined FH was present in nearly 1 of 11 patients
with premature ACS. There is a necessity for more aggressive lipid-lowering therapies
in patients with FH after experiencing ACS.
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Article Info
Publication History
Published online: October 19, 2022
Received in revised form:
September 11,
2022
Received:
June 28,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: none
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
